内分泌代谢科门诊糖尿病口服用药的合理性及其与患者降糖达标的相关性  

Rationality of oral medication for diabetes in the Outpatient Department of Endocrinology and Outpatient Department of Metabolism and its correlation with patients'glucose control

作　　者：岳云霄[1] 刘会超 李琳琳 余儒桓 YUE Yun-xiao;LIU Hui-chao;LI Lin-lin;YU Ru-huan(Department of Pharmacy,Pingdingshan First People's Hospital,Pingdingshan 467000,Henan,CHINA;Department of Science and Education,Pingdingshan First People's Hospital,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平顶山市第一人民医院药学部,河南平顶山467000 [2]平顶山市第一人民医院科教科,河南平顶山467000

出　　处：《海南医学》2024年第23期3440-3444,共5页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20210154)。

摘　　要：目的分析我院内分泌代谢科门诊糖尿病口服用药的合理性及其与患者降糖达标的相关性,为指导临床合理用药提供指导性建议。方法收集2023年1~12月平顶山市第一人民医院内分泌代谢科门诊56457个口服糖尿病药品处方及24783例患者临床资料,统计分析患者基本情况、口服用药方案、口服药物信息、口服药物用药频度(DDDs)、销售金额、排序比(B/A)及不合理用药情况,并对比合理用药与不合理用药患者糖化血红蛋白(HbA1c)达标情况。结果56457个处方中用药方案频次从高到低依次为含ACEI或ARB方案、合用磺脲类药物方案、含双胍类药物方案及阿司匹林方案;所有口服药物中用药频次前3名的是阿卡波糖片、阿司匹林肠溶片、硝酸异山梨酯片,降糖药物用药频次前3名的是阿卡波糖片、二甲双胍片、卡格列净;在所有处方中,DDDs前5名依次为阿卡波糖片、瑞舒伐他汀钙片、二甲双胍片、氨氯地平片、卡格列净片,B/A前5名依次为瑞舒伐他汀钙片、阿卡波糖片、格列美脲片、氨氯地平片、二甲双胍片;在降糖药物中,DDDs前3名依次为阿卡波糖片、二甲双胍片、卡格列净,B/A前3名依次为阿卡波糖片、格列美脲片、二甲双胍片;56457个处方中不合理处方为813个,占1.44%,用法用量不合理占比最高;24783例患者HbA1c总达标率为93.80%(23247/24783),合理用药患者HbA1c总达标率高于不合理用药患者,差异有统计学意义(P<0.05)。结论该院内分泌代谢科门诊糖尿病口服用药基本合理,患者降糖达标情况良好,但存在少数不合理用药行为,不合理用药会降低降糖达标率,需加强对用药处方的审核。Objective To analyze the rationality of oral medications for diabetes in the Outpatient Department of Endocrinology and Metabolism in our hospital and its correlation with patients'glucose control goals,in order to provide guidance for rational clinical medication use.Methods A total of 56457 prescriptions of oral diabetes drugs and 24783 clinical data of patients in the Outpatient Department of Endocrinology and Outpatient Department of Metabolism at Ping-dingshan First People's Hospital from January 2023 to December 2023 were collected.The basic situation of patients,oral medication regimen,information of oral drugs,defined daily doses(DDDs)of oral drugs,consumption sum,ranking ratio(B/A),and irrational drug use were statistically analyzed.And the compliance status of glycated hemoglobin(HbA1c)was compared between patients with rational and irrational medication use.Results Among 56457 prescriptions,the fre-quency of medication regimens from high to low were ACEI or ARB regimen,sulfonylurea combination regimen,bigua-nide regimen,and aspirin regimen.Among all oral drugs,the top 3 were acarbose tablet,aspirin enteric coated tablet,and isosorbide nitrate tablet,while the top 3 hypoglycemic drugs were acarbose tablet,metformin tablet,and caglizin.Among all prescriptions,the top 5 DDDs were acarbose tablet,rosuvastatin calcium tablet,metformin tablet,amlodipine tablet,and caglizin tablet,and the top 5 B/A prescriptions were rosuvastatin calcium tablet,acarbose tablet,glimepiide tablet,amlodipine tablet,and metformin tablet,in order.Among hypoglycemic drugs,the top 3 DDDs were acarbose tab-let,metformin tablet,and caglizin,and the top 3 B/A were acarbose tablet,glimepiride tablet,and metformin tablet.Among the 56457 prescriptions,813 were irrational,accounting for 1.44%,and irrational usage and dosage accounted for the highest proportion.The total HbA1c compliance rate of 24783 patients was 93.80%(23247/24783),and the to-tal HbA1c compliance rate of patients with rational drug use was significantly higher than that o

关 键 词：内分泌代谢科 糖尿病 口服用药 合理性 用药频度 排序比 

分 类 号：R587.1[医药卫生—内分泌]